Temporal trends in infection-related hospitalizations among patients with heart failure: A Danish nationwide study from 1997 to 2017

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal Pub Date : 2024-08-30 DOI:10.1016/j.ahj.2024.08.016

Sørine Lundberg MD , Pauline Knigge MD , Jarl E. Strange MD, PhD , Nina Nouhravesh MD , Andrea K. Wagner MD, PhD , Mariam E. Malik MD , Jawad H. Butt MD, PhD , Charlotte Andersson MD, PhD , Tor Biering-Sorensen MD, PhD , Gunnar Gislason MD, PhD, Prof , Mark C. Petrie MD, PhD, Prof , John McMurray MD, PhD, Prof , Lars Køber MD, DMSc , Emil L. Fosbol MD, PhD , Morten Schou MD, PhD, Prof

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引用次数: 0

Abstract

Background

Despite improved survival, hospitalization is still common among patients with heart failure (HF).

Objective

This study aimed to examine temporal trends in infection-related hospitalization among HF patients and compare it to temporal trends in the risk of HF hospitalization and death.

Methods

Using Danish nationwide registers, we included all patients aged 18 to 100 years, with HF diagnosed between January 1, 1997 and December 31, 2017, resulting in a total population of 147.737 patients. The outcomes of interest were primarily infection-related hospitalization and HF hospitalization and secondarily all-cause mortality. The Aalen Johansen's estimator was used to estimate 5-year absolute risks for the primary outcomes. Additionally, cox analysis was used for adjusted analyses.

Results

The population had a median age of 74 [64, 82] years and 57.6 % were males. Patients with HF had a higher risk of infection over time 16.4 % (95% CI 16.0-16.8) in 1997 to 2001 vs 24.5% (95% CI 24.0-24.9) in 2012 to 2017. In contrast, they had a lower risk of HF hospitalization 26.5% (95% CI 26.1-27.0) in 1997 to 2001 vs 23.2% (95% CI 22.8-23.7) in 2012 to 2017. The risk of infection stratified by infection type showed similar trends for all infection types and marked the risk of pneumonia infection as the most significant in all subintervals.

Conclusion

In the period from 1997 to 2017, we observed patients with HF had an increased risk of infection-related hospitalization, driven by pneumonia infections. In contrast, the risk of HF hospitalization decreased over time.

Abstract Image

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心力衰竭患者感染相关住院治疗的时间趋势：1997-2017 年丹麦全国性研究。

背景：尽管生存率有所提高，但心力衰竭（HF）患者住院治疗的情况仍很普遍：尽管生存率有所提高，但心力衰竭（HF）患者住院治疗仍很常见：本研究旨在探讨心衰患者感染相关住院治疗的时间趋势，并将其与心衰住院和死亡风险的时间趋势进行比较：通过丹麦全国范围内的登记，我们纳入了所有年龄在18-100岁之间、在1997年1月1日至2017年12月31日期间确诊为心房颤动的患者，总人数为147737人。研究结果主要是感染相关住院治疗和心房颤动住院治疗，其次是全因死亡率。Aalen Johansen 估计器用于估计主要结果的五年绝对风险。此外，还采用了 cox 分析法进行调整分析：研究对象的中位年龄为 74 [64, 82] 岁，57.6% 为男性。1997-2001年，高血压患者的感染风险为16.4%（95% CI 16.0-16.8），而2012-2017年为24.5%（95% CI 24.0-24.9）。相比之下，1997-2001年与2012-2017年，他们的心房颤动住院风险分别为26.5%（95% CI 26.1-27.0）和23.2%（95% CI 22.8-23.7）。按感染类型分层的感染风险显示出所有感染类型的相似趋势，并标志着肺炎感染风险在所有子区间内最为显著：1997年至2017年期间，我们观察到，在肺炎感染的驱动下，高血压患者与感染相关的住院风险增加。相比之下，随着时间的推移，心房颤动住院风险有所降低。

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来源期刊

American heart journal 医学-心血管系统

CiteScore

8.20

自引率

2.10%

发文量

214

审稿时长

38 days

期刊介绍： The American Heart Journal will consider for publication suitable articles on topics pertaining to the broad discipline of cardiovascular disease. Our goal is to provide the reader primary investigation, scholarly review, and opinion concerning the practice of cardiovascular medicine. We especially encourage submission of 3 types of reports that are not frequently seen in cardiovascular journals: negative clinical studies, reports on study designs, and studies involving the organization of medical care. The Journal does not accept individual case reports or original articles involving bench laboratory or animal research.